Definition

Skin cancer is an abnormal growth of skin cells and is one of the most common cancers in the world. Cancer is not a contagious disease. There are many types of skin cancer apart from melanoma, which will be discussed in this article, namely basal cell carcinoma and squamous cell carcinoma. Types of skin cancers are distinguished by the cells involved.

Causes

Skin cancer occurs due to genetic (DNA) abnormalities or mutations in skin cells. Normally, cells have a fixed life span and will die in due course to be replaced with new cells. This genetic mutation could cause skin cells to continue developing uncontrollably and not die. Generally, skin cancer starts in the epidermis or the top layer of the skin. The epidermis comprises three main cells: squamous cells, basal cells, and melanocytes, which produce melanin (the pigment that gives skin its color). The type of cancer differs depending on which one of the skin cell types mutated.

Generally, damage to the DNA of skin cells is caused by ultraviolet (UV) radiation from sun exposure and the light emitted by tanning machines. However, this theory cannot explain why skin cancer can also occur in non-sun-exposed areas of the skin. Therefore, many other factors could trigger skin cancer, such as toxic material exposure or diseases that lower the immune system.

Risk Factor

Factors that increase the risk of developing skin cancer are:

Fair Skin

While people of any skin color can get skin cancer, fair-skinned people have less skin pigment. The pigment protects the skin from damaging UV radiation, making it more susceptible to skin cancer. People who have light-colored hair and irises, freckles, and those who easily get sunburn are also more at risk of skin cancer.

History of Sunburn

If you often go outdoors or have sunburns to the point of developing blisters on your skin, you are at a higher risk for sunburn. People who spend much time in the sun could develop skin cancer later, especially if they don't wear sunscreen. Tanning could also increase the risk of skin cancer, as tanning machines emit UV rays.

Living in Warm or High-Altitude Climates

People who live in warm climates are exposed to the sun more than people who live in cold climates. Also, the sun's rays are stronger and emit more radiation at high altitudes.

Moles

People with many moles or abnormal-looking moles are more at risk for skin cancer. Abnormal moles have irregular shapes and are larger than most moles. These moles are more likely to develop cancerous changes. If you have a mole like this, keep an eye on its shape over time

Family History

If one of your parents or siblings has a history of skin cancer, then your risk of developing skin cancer is higher. If you have had skin cancer, your risk of developing it again is also increased.

Other Health Conditions

Medical conditions or diseases that weaken your immune system, such as HIV/AIDS or organ transplant recipients taking immunosuppressant medicines, can increase your risk of developing skin cancer. Precancerous skin lesions are also at risk of turning into cancer.

Substances Exposure

Exposure to certain substances, such as arsenic, or receiving radiation therapy for a skin condition can increase the risk of skin cancer, especially basal cell carcinoma.

Symptoms

Skin cancer often occurs in areas exposed to the sun. However, other areas of skin with low sun exposure can also be affected, such as the palms of the hands, beneath the nails, toes, and pubic area. This article will discuss two types of skin cancer other than melanoma.

Basal cell carcinoma

Basal cell carcinoma originates from the skin's basal cells; they’re responsible for producing new skin cells and pushing older skin cells to the skin's surface. This cancer can develop in any area of the skin but is often found on the head, neck, and arms. This type of cancer is most common in fair-skinned people. In this cancer, you can find:

• Small, shiny, flesh-like brown nodules 
• There are sometimes brown or black patches 
• The lump may enlarge over time and may peel or bleed easily

Squamous cell carcinoma

As the name implies, this cancer originates from skin squamous cells. While basal cells are located at the lower part of the epidermis (top layer of the skin), squamous cells are located at the top layer of the epidermis. Squamous cells form the skin surface and are routinely replaced as new cells are formed. This cancer mostly occurs in areas exposed to sunlight, such as the face, ears, back, chest, and hands. Dark-skinned people may develop squamous cell carcinoma in other body parts not frequently exposed to the sun. This type of cancer appears as:

• Small, firm lumps that are red in color
• The surface of the lump is scaly or rough
• The lump is painful, tender and bleeds easily

Other skin cancers

There are other types of skin cancer, although they are quite rare, including:

1. Kaposi sarcoma. This rare cancer develops in skin blood vessels that cause red patches on the skin or mucous membranes. It is commonly found in people with weakened immune systems
2. Merkel cell carcinoma is a small, shiny, and solid nodule that appears above or slightly below the skin and in hair follicles, most commonly found on the head, neck, and body
3. Sebaceous gland carcinoma. Although this cancer is rare, aggressive and usually appears as small, hard, painless nodules, it can occur anywhere, but most often on the eyelids

Diagnosis

To diagnose skin cancer, the doctor could ask about your problems and symptoms, your medical history, and if your family has a history of skin cancer. They could also ask about the existence of lump growth or abnormal skin changes that you feel. After that, the doctor would check your skin.

If the doctor suspects skin cancer, an abnormal skin lump sample will be removed and examined (biopsy). This procedure can determine whether the skin changes or abnormalities are cancerous.

Management

Treatment options for skin cancer vary depending on the size, type, depth, and location of the cancer. Small cancers with clear borders on the skin surface may be able to be surgically removed. However, additional therapies are required to treat the cancer in certain conditions.

Your doctor will tell you about various surgical procedures. Not only that, you could also be informed about many treatment options, such as:

• Radiation therapy, using high-power radiation beams such as x-rays
• Chemotherapy, which uses medicines to kill cancer cells
• Photodynamic therapy, uses a combination of laser light and medicines that make cancer cells more sensitive to light
• Biological therapy, using the body's immune system to kill cancer cells

Complications

Skin cancer can cause damage to the surrounding tissue around the growth, and cancer cells can spread to other organs. In addition, if you have had skin cancer in the past, there is a chance that it may reappear in the future, which could be larger in size coupled with more severe symptoms. Therefore, you may need to have regular medical check-ups to monitor your health.

Prevention

You can reduce your risk of developing skin cancer by:

• Limiting or avoiding exposure to UV radiation, especially during the day
• Wearing sunscreen regularly
• Wearing clothes that protect the skin from UV rays
• Avoiding tanning
• Being careful when using medications that cause the skin to become more sensitive to sunlight
• Get your skin checked if there are any suspicious changes in the skin

When to See a Doctor?

You should consult your doctor if you notice any concerning changes in your skin. However, not all changes refer to signs of skin cancer. The doctor will inspect and check you to determine the cause.

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